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Monday, 16 June 2008
Page: 4901


Mr SIDEBOTTOM (7:20 PM) —I rise to speak on the Dental Benefits Bill 2008 and related bill. Teeth, chompers, pearly whites, fangs or pegs: whatever you choose to call them, teeth and oral health in general play a crucial, basic and sometimes painful role in the health and wellbeing of all Australians. Our teeth are a lifetime investment. They are essential for the most fundamental—and let us not forget delicious—element of being human, eating. Despite their essentialness, though, Australians have come to consider dental health and routine dental checks as secondary or less important than the rest of our health needs. We consider a check-up at the dentist a luxury or an elective item. We do not acknowledge the importance of our teeth to our overall health. We put off going to the dentist, we ignore that toothache and we disregard the health of our teeth as too expensive to deal with. I suspect there are a variety of reasons: comparatively, and unfortunately, the history or culture of pain formerly associated with a visit to the dentist persists; services are not eligible for or part of the Medicare system; the relatively high costs of treatment; and the need by many to take out private health insurance extras to pay for the treatments.

But one of the major contributors has been the inactive role of the former Howard government in relation to supporting the provision of dental health care in Australia, whether this be in a lack of funding directly into a national dental health scheme or in its reluctance to offer national and financial leadership in the training and provision of dental health experts. To blame the states in relation to these matters reflects mostly on the Howard government’s lack of leadership on a vital national health matter. Contrary to attempts by members opposite—and we just heard the member for Paterson repeat himself 20 times in a 10-minute speech that went to 20 minutes—to justify the Howard government’s wilful neglect of dental health under the constitutional guise of arguing it to be a state rather than a federal responsibility, 12 years of neglect by the Howard government followed and it is now simply too tough for too many to get in to the dentist. Many people instead allow the pain to become excruciating before they do anything about it and then, if and when they can manage to get themselves in to see a private dentist, the cost is comparatively high. Many have given up; they have learnt to cope with aching teeth and ignore their poor oral health. Our health as a nation has suffered no end because of this.

Let us take a minute, if we may, to consider the legacy the Howard government left behind in their post-1996 abandonment—and that is what it was—and neglect of national dental health. In 1996 the Howard government scrapped Labor’s Commonwealth dental health scheme, effectively ripping $100 million per annum out of the public dental services. As a result of this, as the second reading speech of the Minister for Health and Ageing, Ms Roxon, on the bill graphically points out, more than 650,000 Australians are now trapped on public dental waiting lists. In addition, some one in three Australians report avoiding going to the dentist due to the cost. A staggering 50,000 people are hospitalised each year in Australia suffering from preventable dental conditions. This puts added pressure on an already bursting public hospital system, particularly in my home state of Tasmania. One in six Australians report avoiding certain foods because of problems with their teeth. Tooth decay is currently Australia’s most prevalent health problem. Gum disease is ranked the fifth most common disease in the nation. More than one-quarter of adult Australians, I understand, are currently suffering from untreated dental decay.

In my home state of Tasmania, the figures are very worrying, but I acknowledge the Bartlett-Giddings Labor government is working hard to tackle the issue. Unfortunately, adult Tasmanians have the worst dental health in Australia. We have the highest rate of tooth loss—14.3 per cent compared to a national average of 8.3 per cent. We have the greatest number of dentures—19 per cent compared to a national average of 15.8 per cent. We have the highest average number of missing teeth and the largest number of people who have not seen a dentist in the past five years—15.4 per cent compared to the national average of 10 per cent. In February 2007, Tasmania’s dental waiting list stood at more than 9,000 people. Of these, 800 people on the north-west coast were on the long-term list.

We must stop and consider for a moment that these statistics represent real people, not just numbers. That is 9,000 people struggling to eat, being kept awake at night and, more often than not, in agony. In Tasmania it can take up to five years just to get into the dentist for a routine check-up. Admittedly things have begun to change, but that is a historical statistic. In 2005 there was one dentist for every 4,000 people in Tasmania. The national average was one dentist for every 2,000 people. Here is another statistic I would like to share with you: nationally, in 2005 there was only one dentist for every 11,500 people eligible to use public services. The Howard government spent the past 12 years refusing to acknowledge these statistics, choosing instead to blame the states—we heard a rendition of the blame game just a moment ago—dismantling the former Keating Labor government’s Commonwealth dental scheme and ripping millions of dollars from the nation’s health system.

What are the implications of this forced neglect of our teeth? Oral health holds the key to our overall health and wellbeing. For 12 years Australians with poor oral health have been sleep deprived, and this has led to all sorts of other health complaints. Poor oral health can trigger all sorts of other medical conditions, as other members have pointed out to the House, including pneumonia, cardiovascular disease and diabetes. Poor oral health is a killer—it kills people. It is linked to premature, low birth-weight babies. Persistent pain has a devastatingly debilitating effect which impacts on every facet of our daily lives. It causes social isolation and poor mental health, puts pressure on personal relationships and can trigger low self-esteem. Indeed, we could spend a whole evening discussing the ramifications of just that last point alone. All of these ailments put significant additional pressure on public health services.

Stop and think for a moment how difficult it might be for someone to get themselves a job or to be approved for a rental property when they have missing or damaged teeth. These problems have increased reliance on welfare payments and public housing. It is serious stuff. It is something you do not think of, but imagine trying to impress someone personally when you have massive problems with oral health or your teeth.

What are we going to do about it, apart from talk about the past? The Dental Benefits Bill, which we are discussing, will allow the Rudd government to deliver on its election promise to provide improved dental services for Australian families and help turn some of these dire statistics around. I regard this as a down payment. This is not enough—nowhere near enough. It is a down payment. It will improve services in two ways: firstly, through the Teen Dental Plan; and, secondly, through the new Commonwealth Dental Health Program. The Rudd government will provide $780 million over five years for these two programs—some $490.7 million over five years to the Teen Dental Plan and $290 million over three years to the Commonwealth Dental Health Program. These commitments will help ease the country’s current dental crisis—I say ‘help ease’; we still have a long way to go—by ending the blame game and working hand in hand with the state governments, for heaven’s sake, not ignoring state needs and gutting health funding like the former Howard government did.

As I have just said, the Rudd government will provide an additional $290 million over three years to improve access to public dental services. Discussions with the states and territories about the introduction of this program are well underway. This money is all targeted at public dental services, to provide additional services to those who need it most: the vulnerable and the needy.

The first task of the new program is to reduce waiting lists by funding an additional one million dental consultations and treatments over the next three years. Strict conditions will be put on the states and territories to ensure the Commonwealth funding goes where it is most needed—to those suffering chronic conditions, to preschool children and the elderly, and to those living in regional areas. This is great news to my electorate of Braddon and, I know, to my colleague the member for Moreton.

I must acknowledge at this point the Rudd government’s decision to discontinue the former government’s Enhanced Primary Care Program, as mentioned by those on the other side. This program introduced by the Howard government allowed GPs to refer people with chronic or complex health conditions to dental and allied health specialists for up to five Medicare rebated treatments in a calendar year. Whilst assisting needy clients—and there is no doubt it did that—the major problem with this scheme was that the Howard government had grossly overestimated the moneys needed to be set aside for these services. So this money was locked up and the majority was not used. And I note the former speaker talked about 300,000 services. That does not mean 300,000 people; it means services. Let us be honest about this stuff. It did help people, and we appreciate that. However, we have to make priority decisions to help more. So, while a small number of people were receiving the service, the unspent moneys, which could have been used for any number of other dental services, were being wasted.

The philosophy behind this government’s decision to discontinue that program is to instead put all available funding into the Commonwealth Dental Health Program. We believe this new system will provide targeted assistance to many more needy clients and those who need it the most.

I would like to now refer to the Medicare Teen Dental Plan. In the last decade, there has been a fourfold increase in tooth decay amongst Australian children. It may in fact shock members and those who may be listening to this debate to learn that currently only about 58 per cent of school-age children have ever seen a dentist—and that is not for positive reasons, let me assure you. This is not acceptable. The Rudd Labor government are committed to fixing it, despite the fact that we come from some considerable way behind—and let us not forget that. So, from 1 July 2008, the government will provide up to $150 per eligible teenager aged 12 to17 years towards an annual preventive dental check-up.

This scheme will have two significant outcomes, we believe. Firstly, it will provide financial assistance to parents to ensure their children keep their teeth in good shape; and, secondly, it will encourage teenagers themselves to continue to look after their teeth once they become independent. The flow-on effect of this objective cannot be underestimated. If we can encourage and educate the next generation about the importance of good dental health then the chronic dental issues we face today will be greatly reduced in the future, which is what any good preventive health program should do.

The Medicare Teen Dental Plan will operate as part of the broad Medicare arrangements, through a new dental benefits schedule. The dental benefits schedule will be administered by Medicare Australia and will operate in a similar manner to the existing Medicare arrangements. However, unlike the Medicare Benefits Schedule, the DBS will be targeted to specific age groups and working families receiving family tax benefit part A.

In closing, the Rudd Labor government will deliver $780 million to Australia’s dental health through the Commonwealth Dental Health Program and Medicare Teen Dental Plan. This will set us up for a whole new level of dental care in Australia and a whole new belief system when it comes to our teeth. But it is a down payment; it is a beginning. It is a re-involvement of the Commonwealth in dental health. It will bring dental health care and access to dental care back to the forefront of Australians’ minds. Our children will be educated and encouraged from a young age to value their teeth as a lifetime investment. Most importantly, it will ease the burden on the public health system well into the future. Unlike those opposite, I welcome this bill.